Neck circumference and cardiovascular outcomes: Insights from the Jackson Heart Study

Abstract

Background: Emerging data suggest that neck circumference (NC) is associated with cardiometabolic risk factors. Limited research is available regarding the association between NC and cardiovascular outcomes in African Americans. Methods: Using data from the Jackson Heart Study, we included participants with recorded NC measurements at baseline (2000-2004). Baseline characteristics for the included population were summarized by tertiles of NC. We then calculated age-and sex-adjusted cumulative incidence of clinical cardiovascular outcomes and performed Cox proportional hazards with stepwise models. Results: Overall, 5290 participants were categorized into tertiles of baseline NC defined as ≤37 cm (N=2179), 38-40 cm (N=1552), and >40 cm (N=1559). After adjusting for age and sex, increasing NC was associated with increased risk of heart failure (HF) hospitalization (cumulative incidence = 13.4% [99% CI, 10.7-16.7] in the largest NC tertile vs. 6.5% [99% CI, 4.7-8.8] in the smallest NC tertile), but not mortality, stroke, myocardial infarction or coronary heart disease (all P≥0.1). Following full risk adjustment, there was a nominal increase in the risk of HF hospitalization with increasing NC, but this was not statistically significant (hazard ratio per 1-cm increase, 1.04 [99% CI, 0.99-1.10], P=0.06).

Use of neck circumference as a predictor of cardiovascular risk in chronic kidney patients undergoing haemodialysis who are candidates for transplantation

“…Several studies have shown an association between NC and elevated BMI, low levels of HDL‐C, elevated triglycerides and insulin resistance biomarkers (insulin, homeostatic model assessment for insulin resistance, etc.) in the adult population 27,28,29,30 . Another study conducted with healthy adult Brazilians participating in the Longitudinal Study of Adult Health (ELSA‐Brasil) showed that NC presented a significant and independent association with high TGL and low HDL‐C, as well as other cardiometabolic risk factors 31 …”

Comparison of neck and waist circumferences for identifying subclinical atherosclerosis in a community‐based population

“…Neck fat, as an ectopic fat depot, is likely to play a role in accelerating atherosclerosis in the vessels of the neck through direct paracrine action, which leads to an increased risk of CVD compared with the risks associated with systemic and central obesity 7‐11 . Baena et al 7 performed ultrasound assessments of C‐IMT in a multicenter prospective cohort and found that there was a positive correlation between NC and C‐IMT in both men and women; moreover, the correlation remained significant after adjusting for age, race, hypertension, diabetes, dyslipidemia, smoking, BMI, and WC.…”

“…Recently, a close correlation between subcutaneous fat accumulation in the upper body and obesity‐related CVD was found, which made NC likely to be a powerful and simple tool for identifying cardiovascular diseases. Previous studies have revealed that NC is closely related to atherosclerosis, stroke and CVD 7‐11 . However, the correlation between NC and subclinical atherosclerosis is not yet clear.…”

Correlations between neck circumference and serum thyroid hormones levels in postmenopausal women with euthyroid and subclinical hypothyroidism

“…The measurement of NC is simple without exposure of the abdomen and minimally affected by breathing and diet, with an explicit anatomic landmark, high repeatability, and low variability. Accumulating studies have confirmed that NC, similar to WC, is a powerful tool for determining obesity or metabolic syndrome and predicting the risks of cardiovascular diseases 13‐15 . Our previous study found that the optimal cut‐off point of NC for the identification of metabolic syndrome was 34.5 cm in women by measuring the visceral fat area using magnetic resonance imaging and accurately evaluating central obesity 15 .…”